Class activity 1: Crop distribution refers to how crops are spread across different regions in Nigeria. Certain crops are found more in one area than the rest because of the environment in which they grow best. Successful adaptation of crops to the climatic and soil conditions of an area is known as Adaptability. Different crops require different climatic and soil conditions for their normal growth and development. THREE ECOLOGICAL REGIONS IN NIGERIA 1. Coastal region 2. Rainforest region 3. Savanna region Coastal region: This region is close to the sea and is marked by mangrove forest. The climate there is humid and receives lots of rainfall. Dominant Crops: Rice, rubber, coconut. States found: Akwa-Ibom, Bayelsa, Cross-Rivers, Delta, Edo, Lagos, Ogun, Ondo and Rivers. RAINFOREST REGION(SOUTH): This region experiences high rainfall throughout the year and lush vegetation. Dominant Crops: Oil palm, banana, plantain, kolanut, cocoa, tubers(cassava and yam). States found: Bayelsa, Cross River, Edo, Ekiti, Ondo, Osun, Rivers, and Taraba. SAVANNAH REGION(NORTH): This region has a dry and wet season with less rainfall than the forest region. It consists of grassland and a few trees. Dominant Crops cereals, legumes, and cotton. These crops adapt to the drier and warmer climate of the savannah and require less water. States found: Enugu, Ekiti, Osun, Oyo, Kwara, Kogi, Benue, Nassarawa, Plateau, and Taraba States

Master Class Activity 1

Master Class Activity 1_TLE 6

Viewpoint 1 A First Class Activity

ECPE BOOK 1 PT 1 READING In-class activity

Above B1 Unit 1 L6 In-class activity

Grade -3 Subject Mathematics Concept: Patterns Chapter/ Topic: Patterns Sub Topic: Identifies simple symmetrical shapes and patterns Objective: Students will be able to identify simple symmetrical shapes and patterns using the universal design of learning, CPA approach, and engaging activities. Materials: Whiteboard and markers Symmetrical shapes and patterns flashcards Pattern blocks Construction paper Scissors Glue Procedure Introduction (5Minutes) Introduce the concept of simple symmetrical shapes and patterns to the students. Explain the concept of symmetry and how it can be found in various shapes and patterns. Show examples of symmetrical shapes and patterns using flashcards and discuss with the students. Activity-1 (10 minutes) Hand out pattern blocks to each student. Instruct students to create symmetrical shapes using the pattern blocks. Once they have created their shapes, have them identify the line of symmetry in each shape. Discuss as a class which shapes are symmetrical and why Activity-2 (10 minutes) Provide students with construction paper, scissors, and glue. Instruct students to create a symmetrical pattern art piece by cutting out shapes and arranging them in a symmetrical pattern. Encourage students to be creative with their designs. Have students share their symmetrical pattern art with the class. Assessment (5 minutes): To assess student understanding, ask students to identify the line of symmetry in various shapes and patterns shown on the whiteboard. Provide feedback to students on their responses to ensure they understand the concept of symmetry.

The LMS has been an essential tool in curriculum design and development and in organizing factors that motivate student learning, especially in online distance learning. However, an LMS can be used in blended, hybrid, and in-class delivery modes. It is a software application designed to help in the administration of courses for both students and instructors. Such systems have been designed for use in learning and teaching activities (Chung et al., 2012). They also provide a variety of interaction methods between instructors and learners to facilitate the learning process better, You must remember well-designed LMS could also help improve student skills, such as effective online learning and self-direction (Norouzi, 2014). Students could use the system to enhance performance (perceived usefulness), and they could use such systems with little effort (perceived ease of use) (Venkatesh & Davis, 2000). A majority of higher education institutions have incorporated LMS systems; they have been used in university systems by schools, faculty members, and instructors (Klobas & McGill,. 2010), Because so much of higher education has been focused on course delivery Chapter3 INSTRUCTIONAL DELIVERY SYSTEMS AND EDUCATIONAL TECHNOLOGY i 71 in a physical classroom, the implementation of an LYS has a;ded institutons in transitioning to new online universe of curriculum de!ivery (Georgou!i, & Guerre. 2NS). Repositories, central databases, and online meeting 'oations are all characteristcs of a management system. As a concept, a 'earning management system is a broad idea and an example of technology's inabifity to be specific in terms of a definition. Several requirements a generat overview of what constitutes a leaming management system, such as those listed above Finally, end-user access is also a part of a learning management system with various levels being set up by security. For example, students have read-onty access, faculty members have read and write access, and technical staff has complete access for support and administrative duties (Graf & Chien, 2009). At its core, a learning management system contains internal or Web-based support and management for numerous aspects of learning and teaching (Hiary & Abu-Shawar, 2009). This allows access from numerous locales, usually on a 24-hour basis. When looking at a university or college, this concept begins to grow greatly depending on the organization's size and scope; department, and degree program. Leaming management systems also go by other names such as course management systems, and their use goes beyond higher education institutions to include businesses and individual instructors. Meis)ar-Tal, Kurtz, and Pieterse (2012) mentioned three primary purposes of an CMS. They include the following: 1. to provide students with digital learning materials; 2. to employ interactive learning activities with students in the forums; and 3. to manage the course and the learners. Faculty members who use an LMS to make available lecture notes and other classroom resources for their face-to-face class create a web-enhanced classroom experience. Regardless of its usage, requirements for classification as a learning management system include several key concepts like the availability of assets over networks, providing hosting, administration. and support. With the requirements set, utilization becomes the focal point. A fully utilized learning management system looks at use at the student level, faculty level, and administration level. proper utilization of learning management systems should mirror traditional higher education goals, enhancing students' experiences. For learninä management systems, this creates a central hub for a class activity. For some classes, all activities work in the learning management system, while others only use its resources for select activities.

Chapter 22 Antihypertensive Drugs Hypertension Defined (JNC-8) Pharmacology Overview 7 main categories of drugs to treat HTN Adrenergic drugs (old friend) Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARBs) Calcium channel blockers (CCBs) Diuretics Vasodilators Direct renin inhibitors A. Adrenergic Drugs: 5 Subcategories and where they act A1. Adrenergic neuron blockers (central and peripheral)- we won’t talk about this A2. Alpha1 receptor blockers (peripheral) A3. Alpha2 receptor agonists (central) A4. Beta receptor blockers (peripheral) A5. Combined α and β receptor blockers (peripheral) A2. Peripherally Acting Adrenergic DrugAlpha1 Blockers (we’ve met these) Doxazosin, prazosin, alfuzosin Block alpha1-receptors which causes BP to decrease Reduces peripheral vascular resistance and BP by dilating both arterial and venous blood vessels Main Use: benign prostatic hyperplasia (BPH) Alpha1 Blockers REMEMBER Tamsulosin (Flomax)* is an α1 blocker BUT *Tamsulosin is not used to control BP, just for BPH. A3. Centrally Acting Adrenergic DrugsAlpha 2 agonist Clonidine and methyldopa 1- Stimulate alpha2-adrenergic receptors. in the brain Decreases sympathetic outflow from the CNS which decreases NE production 2. Stimulate alpha2-adrenergic receptors in kidneys remember alpha 2 opposes alpha 1 Dilates peripheral blood vessels → lowers peripheral resistance → Results in decreased BP So ….Clonidine (Catapres) Used primarily for its ability to decrease blood pressure in an urgent setting Also use in opioid withdrawal as previously discussed Oral (multiple times a day), and topical patch formulations Do not stop abruptly as it may lead to rebound hypertension In reality, Clonidine and methyldopa Not prescribed as first-line home antiHTN drugs High incidence of unwanted adverse effects: orthostatic hypotension, fatigue, and dizziness MIGHT be uses as adjunct drugs after other drugs have failed, in conjunction with other antiHTN such as diuretics A4. Adrenergic Drugs Selective Beta 1 Blockers Metoprolol, Atenolol Reduction of HR through β1 receptor blockade (remember adrenergic blocking of this receptor???) HR results in BP Cause reduced secretion of renin = BP A4. Adrenergic Drugs Selective Beta1 Blockers Nebivolol (Bystolic) Uses: hypertension and HF Action: blocks β1 receptors and produces vasodilatation, which results in a decrease in SVR High doses loses selectivity and blocks both β1 and β2 Less sexual dysfunction All BB- Do not stop abruptly; must be tapered over 1 to 2 weeks A4. Adrenergic Drugs NONSelective Beta Blockers Propranolol Acts equally on β1 and β2 Other uses include situational anxiety associated with public speaking, test taking As mentioned on previous slide, nebivolol at high doses becomes beta nonselective A5. Dual-Action Adrenergic Drugs α1 and β Receptor Blockers Dual antihypertensive effects of reduction in heart rate (beta1 receptor blockade) and vasodilation (alpha1 receptor blockade) Examples are carvedilol (common) and labetalol (not as common) A5. Dual-Action Adrenergic Drugs α1 and β Receptor Blockers Carvedilol (Coreg) Widely used drug that is well tolerated Uses: HTN, mild to moderate HF in conjunction with digoxin, diuretics, and ACE inhibitors Contraindications: severe bradycardia or unstable HF, bronchospastic conditions such as asthma, and various cardiac conduction problems Adrenergic Drugs Indications - HTN But also for Glaucoma (topical) BPH: doxazosin, prazosin, and terazosin (2 for 1) Management of severe HF when used with cardiac glycosides and diuretics Contraindications Acute HF- have to stabilize first MOAIs- yeah doesn’t everything interact with MAOIs? Peptic ulcers Severe liver/kidney disease Asthma (with beta blockers) Adrenergic Drugs: Adverse Effects Orthostatic hypotension 1st-dose syncope Rebound hypertension with abrupt discontinuation Most common: Dry mouth, drowsiness, constipation, sedation Interactions- always check for specific drug interactions Can cause additive CNS depression with alcohol, benzodiazepines, opioids Question #1 When administering an alpha-adrenergic drug for hypertension, it is most important for the nurse to assess the patient for the development of what response? Hypotension Hyperkalemia Oliguria Respiratory distress Answer A Hypotension This is a key point in patient education These drugs have strong vasodilating properties and may cause severe hypotension, especially at the beginning of therapy. B. Angiotensin-Converting Enzyme Inhibitorsaka ACE Inhibitors or ACEi Large group of safe and effective drugs Currently are 10 ACEi Often used as first-line drugs for HF and hypertension May be combined with a thiazide diuretic, loop diuretic, or Calcium Channel Blocker (CCB) You need to understand the basics ACE Inhibitors: Review RAAS ACE converts angiotensin I, formed through the action of renin, to angiotensin II Angiotensin 2 is a potent vasoconstrictor and also induces aldosterone secretion by the adrenal glands Aldosterone stimulates sodium resorption (H20 follows Na Both act to raise BP which causes kidneys to reduce renin production ACEi= Great drug to treat HTN BUT contraindicated in pregnancy (2nd,3rd trimester due to fetal renal damage) and breastfeeding first few weeks after birth B. ACE Inhibitors - PRIL Lisinopril (Prinivil) super common, often the 1st drug Enalapril (Vasotec) also common Captopril (Capoten) great if liver disease present Benazepril (Lotensin) Fosinopril (Monopril) Perindopril (Aceon) Quinapril (Accupril) Ramipril (Altace) Trandolapril (Mavik) Primary Effects of the ACE Inhibitors Prevent Na (and H2O) resorption by inhibiting aldosterone secretion (volume reduction) (GO BACK TO RAAS DIAGRAM) blood volume decreases work of the heart preload, or the left ventricular end-diastolic volume which is important in HF ACE SUMMARY OF ACTIVITY 1) Prevent vasoconstriction caused by angiotensin 2 (2) Prevent aldosterone secretion  less sodium and water resorption Cardioprotective Effects of ACEi They slow progression of left ventricular hypertrophy (ventricular remodeling) after MI so considered cardioprotective ACE inhibitors have been shown to decrease morbidity and mortality in patients with HF Renal Protective Effects of ACEi ACE inhibitors: reduce glomerular filtration pressure by volume reduction Cardiovascular drug of choice for patients with diabetes since it helps protect kidneys by reducing pressure. Sometimes used low dose for kidney protection with DM without HTN B. ACEi Enalapril (Vasotec) Only ACEi available in both oral and IV Enalapril IV does not require cardiac monitoring Oral enalapril: prodrug (metabolized in liver) Improves patient’s chances of survival after an MI Reduces the incidence of HF B. ACEi Captopril (Capoten) Uses: prevention of ventricular remodeling after MI; reduce the risk of HF after MI Shortest half-life Must be administered multiple times throughout the day so this limits its use Not a prodrug so good for patient with liver disease Question #2 A patient with diabetes has a new prescription for the ACE inhibitor lisinopril. She questions this order because her provider has never told her that she has hypertension. What is the best explanation for this order? The doctor knows best The patient is confused This medication has cardioprotective properties This medication has a protective effect on the kidneys for patients with diabetes Answer D ACE inhibitors have been shown to have a protective effect on the kidneys because they reduce glomerular filtration pressure. This property makes them the cardiovascular drug of choice for patients with diabetes. Question #3 A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension. Which drug will most likely be ordered for this patient? Clonidine Prazosin Diltiazem Captopril Answer D Captopril Captopril is not a prodrug; therefore, it does not need to be metabolized by the liver to be effective. This is an advantage in patients with liver disease. ACE Inhibitors: Adverse Effects *Dry, nonproductive cough, which reverses when therapy is stopped. This is a class effect Dizziness- Note: First-dose hypotensive effect may occur Headache & Fatigue Possible hyperkalemia ** Angioedema: rare but potentially fatal Not safe in pregnancy-are contraindicated during the second and third trimesters of pregnancy because of increased risk of fetal renal damage C. Angiotensin II Receptor Blockers(ARB) Considered an alternative to ACEi Less likely to cause a dry cough and hyper K+ that is common with ACE inhibitors Angiotensin II Receptor Blockers: Mechanism of Action Go back to RAAS diagram! ARBs affect primarily 2 places 1. Vascular smooth muscle - blocks vasoconstriction 2. Adrenal gland -Selectively blocks the binding of Ang 2 to certain Ang 2 receptors inhibiting secretion of aldosterone Lowers volume retention and BP Angiotensin II Receptor Blockers -ARTAN Losartan (Cozaar)- very common Eprosartan (Teveten) Valsartan (Diovan) Irbesartan (Avapro) Candesartan (Atacand) Olmesartan (Benicar) Telmisartan (Micardis) Azilsartan (Edarbi) C. ARB Losartan (Cozaar) Beneficial in patients with HTN and HF Used with caution in patients with kidney or liver dysfunction and in patients with renal artery stenosis ***Not safe for breastfeeding women and should not be used in pregnancy (Cat C 1st trimester, Cat D 2nd-3rd trimester), potential fetal toxicity Appear to be equally effective for the treatment of hypertension and well tolerated ARBs less likely to cause cough and hyperK+ but can still happen Evidence that ARBs are associated with lower mortality after MI than ACE inhibitors Never take ACEi and ARBs at the same time* 5. Calcium Channel Blockers (CCB) Primary use: HTN, angina, some dysrhythmias Cause smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing muscle contraction Results in: Relaxed blood vessels to the heart Decreased peripheral smooth muscle tone Decreased SVResistance Decreased BP E. Diuretics First-line antiHTN in JNC 8 guidelines Decreases fluid volume The results from diuresis: preload, Peripheral resistance Overall effect  Decreased workload of the heart and decreased BP Thiazide diuretics are the most commonly used diuretics for HTN Ie hydrochlorothiazide (HCTZ), chlorthalidone We will discuss diuretics further in the chapter on diuretics F. Vasodilators Directly relax arterial or venous smooth muscle (or both) Results in: Decreased SVR Decreased afterload Peripheral vasodilation Indicated for treatment of HTN May be used in combination with other drugs F. Vasodilators Hydralazine (Apresoline) Orally: routine cases of essential hypertension Injectable: hypertensive emergencies BiDil: specifically indicated as an adjunct for treatment of HF in African-American patients F. Vasodilators Sodium Nitroprusside (Nitropress) *Sodium nitroprusside and IV diazoxide are reserved for the management of hypertensive emergencies. Contraindications: severe HF, known inadequate cerebral perfusion (especially during neurosurgical procedures) F. Vasodilators Adverse Effects Hydralazine: dizziness, headache, tachycardia, edema, dyspnea, N/V/D, vitamin B6 deficiency, rash Sodium nitroprusside: hypotension, bradycardia, decreased platelet aggregation, rash G. Direct Renin Inhibitors Aliskirin (Tekturna) Blocks the RAS pathway at the point of activation. Inhibiting renin production prevents the downstream production of Ang II (potent vasoconstrictor) Adverse effects: N/V, severe hypotension, hyponatremia, hyperkalemia… Contraindicated in patients with DM taking ACEi or ARB Miscellaneous Antihypertensives Eplerenone (Inspra) Newer class of drugs called selective aldosterone blockers (remember RAAS?) Reduces BP by blocking the actions of aldosterone at its corresponding receptors in the kidney, heart, blood vessels, and brain Indications: routine treatment of hypertension and for post-MI HF Contraindicated if serum potassium levels are high (above 5.6 mEq/L) A Special Form of HTNTreatment of Pulmonary Hypertension Sildenafil and Tadalafil Commonly used for erectile dysfunction Used for pulmonary hypertension but with different trade names Sildenafil: Revatio* (Viagra for ED) Tadalafil: Adcirca* (Cialis for ED)

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